MARK DAVID WAGNER (NPI# 1649211764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649211764 |
Entity Type | Individual |
Full Name | MARK DAVID WAGNER |
Credential | M.D. |
Practice Address |
1000 Dexter Ave N Ste 320 Seattle WA 98109-4878 |
Practice Telephone | 2066200333 |
Practice Fax Number | 2064627520 |
Mailing Telephone | 2066200333 |
Mailing Fax Number | 2064627520 |
Enumeration Date | 2006-06-09 |
Last Update Date | 2019-05-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
MD00022633 | WA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | LABOR AND INDUSTRY | 378219 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
1000 Dexter Ave N Ste 320, Seattle, WA 981094878 | 2066200333 | 2064627520 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528419074 | Mark Vincent Wagner | Dentist | 2600 Village Pkwy Ste 120, Highland Village, TX 75077-3285 | 2016-06-27 |
1467845487 | Mark Wagner | Health Educator | 600 Cornell Ave, Hagerstown, MD 21742-4500 | 2015-03-16 |
1265863112 | Mark Wagner | Dentist | 24 Old Plantation Way, Pikesville, MD 21208-6375 | 2013-12-03 |
1881967016 | Mark Allen Wagner | Physical Therapist | 4046 Arezzo Dr, Longmont, CO 80503-4157 | 2012-02-19 |
1780737924 | Mark Wagner | Psychologist | 23 Pokonoket Ave, Sudbury, MA 01776-2320 | 2007-01-19 |
1033202502 | Mark Elliot Wagner | Family Medicine | 623 North 5th Street, Reading, PA 19601 | 2006-10-02 |
1700821709 | Mark S Wagner | Psychiatry & Neurology | 515 Cabrillo Park Dr, Suite 120, Santa Ana, CA 92701-5016 | 2006-06-17 |
1336130087 | Mark Andrew Wagner | Radiology | 2740 M St, Merced, CA 95340-2813 | 2005-11-02 |
1992358741 | Mark Wagner | Counselor | 540 Riverside Dr Ste 8, Salisbury, MD 21801-5352 | 2019-07-22 |
1134488752 | Mark E Wagner | Counselor | 900 W Norfolk Ave, Norfolk, NE 68701-5006 | 2012-05-16 |
Street Address |
1000 DEXTER AVE N STE 320 |
City | SEATTLE |
State | WA |
Zip Code | 98109-4878 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497356158 | Rachel E Tarkowski | Dietitian, Registered | 1000 Dexter Ave N Ste 320, Seattle, WA 98109-4878 | 2020-11-07 |
1962927632 | Therapy Management Services, Pllc | Physical Therapist | 1000 Dexter Ave N Ste 320, Seattle, WA 98109-3582 | 2017-08-03 |
1104244045 | Amy Colten | Physical Therapist | 1000 Dexter Ave N Ste 320, Seattle, WA 98109-4878 | 2014-03-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710590179 | Direct Urgent Care Inc | Internal Medicine | 220 6th Avenue North, Seattle, WA 98109 | 2020-08-26 |
1073147104 | Hannah Christine Hoyt | Registered Nurse | 1354 Aloha St, Seattle, WA 98109 | 2020-02-27 |
1508402645 | Emily Elizabeth Rock | Counselor | Rain City Integrative Clinic, 2730 Westlake Ave N, Seattle, WA 98109 | 2019-11-25 |
1770048464 | Roger Leach | Massage Therapist | 4162, Roy Street, Seattle, WA 98109 | 2019-02-06 |
1306316658 | Laura Katie Richer | Counselor | 1817 Queen Anne Ave. N., 204, Seattle, WA 98109 | 2018-11-29 |
1912492828 | One Medical Group of Washington, P.C. | Psychologist | 625 Boren Avenue North, Seattle, WA 98109 | 2018-06-25 |
1942793526 | Washington Dental Corporation, PC | Dentist | 527 Boren Ave N, Seattle, WA 98109 | 2018-06-08 |
1417449968 | Chelsie Mccalla | Occupational Therapy Assistant | Mirabella, 116 Fairview Ave N, Seattle, Seattle, WA 98109 | 2018-05-31 |
1710405964 | Next Level Sports Performance Consulting | Clinic/Center | 24 Roy Street, #461, Seattle, WA 98109 | 2017-09-07 |
1679091953 | Amy Ly Indorf | Pharmacist | 825 Eastlake Ave E #msg5-90, Seattle, WA 98109 | 2017-09-06 |
Find all providers in zip 98109 |
Taxonomy Code | 207QS0010X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Sports Medicine |
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497173991 | Ashley Austin | Family Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0816 | 2014-04-01 |
1871859942 | Brian Kenneth Snitily | Family Medicine | 601 Broadway Fl 6, Seattle, WA 98122-5330 | 2012-04-03 |
1316142862 | Emily L Cooper | Family Medicine | 400 N 34th St, 300, Seattle, WA 98103-8600 | 2007-06-15 |
1063563229 | Maxine J. Weyant | Family Medicine | 901 Boren Ave, Suite 900, Seattle, WA 98104-3595 | 2007-01-15 |
1629177225 | Sports Medicine Group | Family Medicine | 10330 Meridian Ave N, Suite 300, Seattle, WA 98133-9451 | 2006-09-21 |
1659487056 | Jordan S D Y Chun | Family Medicine | 1100 9th Ave, Seattle, WA 98101-2756 | 2006-08-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326565110 | Family Care Network, Pllc | Family Medicine | 3130 Squalicum Pkwy Ste 110, Bellingham, WA 98225-1940 | 2017-08-23 |
1578682100 | Robert Stewart Nicol | Family Medicine | 23512 Ne 206th St, Battle Ground, WA 98604-9699 | 2007-03-28 |
1912033663 | Richard Terril Jacobs | Family Medicine | 1351 Fowler St, Richland, WA 99352-4714 | 2007-02-26 |
1821132481 | James E Hult | Family Medicine | 800 N 5th Ave # 101, Sequim, WA 98382-3045 | 2007-02-16 |
1598874430 | Patrick Z Pearce | Family Medicine | 730 N Hamilton St, Spokane, WA 99202-2045 | 2006-08-30 |
1265450514 | Lawrence J Greenblatt X | Family Medicine | 1407 116th Ave Ne Ste 102, Bellevue, WA 98004-3819 | 2006-07-17 |
1528015229 | Public Hospital District #1 of King County | Family Medicine | 3600 Lind Ave Sw, Suite 170, Renton, WA 98055-4934 | 2006-05-28 |
1063486074 | Warren Billings Howe | Family Medicine | 516 High St, Wwu Student Health (ms-9132), Bellingham, WA 98225-5946 | 2006-02-15 |
1588280804 | Rainier Family and Sports Medicine P C | Family Medicine | 16202 64th St E Ste 104, Sumner, WA 98390-3028 | 2020-06-23 |
1417469404 | Maksportsmd | Family Medicine | 19110 Bothell Way Ne Ste 102, Bothell, WA 98011-2970 | 2017-10-30 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.